Mirror Therapy for Hand Function Recovery in Acute Stroke

Effectiveness of Mirror Therapy in Improving Motor Recovery and Hand Function in Patients With Acute Stroke A Randomized Controlled Trial

Randomized controlled trial to determine whether mirror therapy (MT), added to conventional physiotherapy, improves upper-limb motor recovery, hand function, spasticity, and range of motion (ROM) in acute stroke compared with conventional physiotherapy alone. Outcomes include ARAT, Motor Assessment Scale, Modified Ashworth Scale, and goniometric ROM.

Stroke causes significant upper-limb impairment in the acute stage; early, targeted rehabilitation leverages heightened neuroplasticity. Mirror therapy uses a mid-sagittal mirror to reflect movements of the non-paretic limb, creating the illusion of normal movement in the paretic limb, recruiting mirror neuron circuits and facilitating motor relearning. Prior work suggests MT can improve fine and gross motor skills, reduce spasticity, and increase active ROM. This trial operationalizes a pragmatic MT protocol integrated with standard inpatient/outpatient physiotherapy in acute stroke.

Inclusion Criteria:

• Age 40-55 years
• Acute ischemic or hemorrhagic stroke within the last 1 month
• Unilateral hemiparesis/hemiplegia
• Medically stable and cleared for rehabilitation
• Able to follow verbal instructions; MMSE ≥ 24
• Provides written informed consent

Exclusion Criteria:

• Recurrent stroke or bilateral involvement
• Severe cognitive impairment (MMSE < 24)
• Visual field deficits, unilateral neglect, or severe aphasia interfering with MT
• Other neurological disorders (e.g., Parkinson's, MS)
• Orthopedic conditions affecting upper limb/trunk
• Uncontrolled cardio-respiratory disease limiting exercise
• Severe spasticity (MAS ≥ 3) in affected limb
• Concurrent enrollment in other interventional trials
• Inability/refusal to consent